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RECEIVED <br /> W <br /> OCT 0 4 2018 <br /> w rENVIRONMENTAL HEALTH � Y <br /> San uin �� Health Sertirices PERMIT/SERVICES Report for the month of <br /> Etwirorrmentil—HUM Seaku <br /> P100 O Box 2009. N_Sara Joaquin SL) Septic Tank and Cesspool Sub€nitteInc. <br /> Stockton,California,95209 Cleaners Report <br /> Fax 4;fi 08 Address:16S$3 <br /> o Must be submitted by the 12''of each month <br /> 0 <br /> Date Name of Property Owner Address where work w;as performed type waste gal.pumped disposal site <br /> co [I— e �Z 5Z t } fD <br /> O YAn/p22� <br /> U ci <br /> Le <br /> [ << ti <br /> 51Y, Q 2E5- ci. << <br /> t„ I O � 9-52,45 ii r t i t <br /> /r 10.332) C�_t.►)" R -Z_ <br /> H �.. tib ) tl If /a It fi � <br /> '' e &043 g q�ZjW it r f 12-00 <br /> i t Ei <br /> ,1-13 Cyrr'lL Sat 5 <br /> tg51 t it E i � tt f t o <br /> o [� 3 CE m <br /> N 0 ��u� <� ZvC) ct <br /> � The following excerpt frorn the co&of Federal Regulations.Section 4013&Report must be signed by a corporate of er who can legally bind the <br /> coW <br /> 3 certify under petty of taw that this document and all attachments were prepared under my direction or supervision. <br /> o <br /> U a, <br /> O <br /> e <br /> 0 0 0 0 1 <br />